Individual provider Active NPI

Oleg Uryasev

  • Emergency Medicine Physician
  • Santa Fe, NM
National Provider Identifier
1134539174
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD2017-0084 Issued in NM
Practice address
1640 Old Pecos TRL
Suite H
Santa Fe, NM 87505-4776
Phone
(505) 992-0233
NPI assigned
Apr 29, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD2017-0084 NM Primary
Emergency Medicine Physician 207P00000X V5618 TX
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1640 Old Pecos TRL
Suite H
Santa Fe, NM 87505-4776

Mailing address

1640 Old Pecos TRL
Suite H
Santa Fe, NM 87505-4776

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260610002346 PA Order and Referring Only - Sports MedicinePractitioner - Sports Medicine 4183844889

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94.24 of 100Reported as group
Quality
98.74
Improvement activities
40
Cost
83.11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD2017-0084NMMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Los Alamos Emergency Medical Associates Inc Emergency Medicine CurrentSince Oct 3, 2020 Accepting new patients
Emergency Medicine Services of TX, PLLC Emergency Medicine CurrentSince Jul 3, 2025 Accepting new patients
Acs Primary Care Physicians Southwest, PA Emergency Medicine CurrentSince May 1, 2025 Accepting new patients

Locations

3917 West Rd
Los Alamos, NM 87544
Phone (505) 661-9584

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

100 E Alton Gloor Blvd
Brownsville, TX 78526
Phone (956) 350-7000

225 E Parkwood Ave
Friendswood, TX 77546
Phone (281) 549-9400

2901 4th St
Longview, TX 75605
Phone (281) 371-1800

11100 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 770-7000

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

26306 Kuykendahl Rd
Tomball, TX 77375
Phone (346) 246-7700

Interoperability endpoints

  • Direct secure messaging: ouryasev1275017@ahs.direct-ci.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1398729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1134539174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 OLD PECOS TRL",
            "address_2": "SUITE H",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 OLD PECOS TRL",
            "address_2": "SUITE H",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054776",
            "telephone_number": "505-992-0233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URYASEV",
        "first_name": "OLEG",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-29",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NM",
            "license": "MD2017-0084",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "V5618",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

Verify at the official NPI Registry.